Page 17 - 2018-19 myNEXUS Benefit Guide
P. 17
myNEXUS
VISION COVERAGE Bi-Weekly
Pre-Tax
Because symptoms of health conditions often do not appear until damage has Contributions
already occurred, eye exams are a great way to keep tabs on what is happening Employee $2.60
in your body. Your eyes are the only place in your body which provide a clear Employee and $4.92
Spouse
view of your blood vessels, arteries, and a cranial nerve which can tell your Employee and $5.77
doctor a lot about your overall health. Our vision insurance coverage, offered Child(ren)
in partnership with National Vision Administrators (NVA), is designed to Family $8.12
meet a variety of needs.
Find an In-Network Provider
Remember to visit in-network providers to receive the deepest level of Go365 Wellness
Program Reminder
discount on your services. To find a participating in-network provider in your You and your eligible family
area go to www.e-nva.com. members can earn points as
National Vision Administrators part of the Go365 wellness
In-Network Out-of-Network program when you visit your
Copay dentist or receive a vision exam.
Exam $10 $45 allowance
Materials $25 See below
Lenses
Single $25 copay $40 allowance
Bifocal $25 copay $60 allowance
Trifocal $25 copay $80 allowance
Lenticular $25 copay $100 allowance
Frames
$130 allowance and $70 allowance
20% discount on any
balance over $130
Contacts
Elective $125 allowance and $125 allowance
10-15% off remaining
balance
Non-Elective Covered 100% $210 allowance
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of 12 months
lenses)
Frames 24 months
This is a high level summary of your benefit coverage. Full coverage details are
available in your summary plan description (SPD). In the event there is a discrepancy
between what is reflected in this guide and what is communicated in your SPD, the
terms of your SPD will prevail.
17
VISION COVERAGE Bi-Weekly
Pre-Tax
Because symptoms of health conditions often do not appear until damage has Contributions
already occurred, eye exams are a great way to keep tabs on what is happening Employee $2.60
in your body. Your eyes are the only place in your body which provide a clear Employee and $4.92
Spouse
view of your blood vessels, arteries, and a cranial nerve which can tell your Employee and $5.77
doctor a lot about your overall health. Our vision insurance coverage, offered Child(ren)
in partnership with National Vision Administrators (NVA), is designed to Family $8.12
meet a variety of needs.
Find an In-Network Provider
Remember to visit in-network providers to receive the deepest level of Go365 Wellness
Program Reminder
discount on your services. To find a participating in-network provider in your You and your eligible family
area go to www.e-nva.com. members can earn points as
National Vision Administrators part of the Go365 wellness
In-Network Out-of-Network program when you visit your
Copay dentist or receive a vision exam.
Exam $10 $45 allowance
Materials $25 See below
Lenses
Single $25 copay $40 allowance
Bifocal $25 copay $60 allowance
Trifocal $25 copay $80 allowance
Lenticular $25 copay $100 allowance
Frames
$130 allowance and $70 allowance
20% discount on any
balance over $130
Contacts
Elective $125 allowance and $125 allowance
10-15% off remaining
balance
Non-Elective Covered 100% $210 allowance
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of 12 months
lenses)
Frames 24 months
This is a high level summary of your benefit coverage. Full coverage details are
available in your summary plan description (SPD). In the event there is a discrepancy
between what is reflected in this guide and what is communicated in your SPD, the
terms of your SPD will prevail.
17
